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General NPI Number Information
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NPI Number | 1588433726
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Entity Type | Organization
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Legal Business Name | DESERT ZEN HEALTHCARE
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Dates
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Enumeration Date | 12/29/2023
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 11611 S FOOTHILLS BLVD STE F
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City | YUMA
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State | AZ
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Zip | 85367-5845
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Country | US
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Telephone | 282-479-2779
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Fax |
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Provider Business Mailing Address
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Address Line | 11611 S FOOTHILLS BLVD STE F
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City | YUMA
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State | AZ
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Zip | 85367-5845
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Country | US
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Telephone | 928-247-9277
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Fax |
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Authorized Official
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Title or Position | ADMIN ASSIST/BILLING
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Name | HEATHER CHARLES
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Credential |
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Telephone | 928-247-9277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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